Areas of Expertise
Heart Failure & General Cardiology
I was in love with heart failure since my early days in medical school. Over the last 13 years as a consultant and heart failure lead my experience in heart failure has extended to the most complex and advanced cases. I believe in holistic care for heart failure that ranges from simple medical therapy, to control of comorbidities, support with exercise training, intravenous iron, rate control, device therapy, cardioversion/ablation, surgical options where needed, palliative care, and where indicated ventricular assist devices and cardiac transplantation. I attach great importance to patient choice and quality of life. I have developed many innovative heart failure services in my hospital as described in the first page. I am not only passionate about heart failure but am almost emotional about it, about my successes and non-successes which continue to be immensely educational. I like a challenge in any general cardiology problem to engage my wide experience and am always delighted to take anything on.
Cardiorenal syndrome is a very common and difficult medical disorder that frequently stems from heart failure but may exist with any form of cardiac disease. These patients with both cardiac disease and kidney impairment have little evidence on how to manage them. Over the last 3 years I have conducted a monthly cardio-renal clinic jointly with a renal physician to try to understand and effectively treat this group of patients. We have achieved a degree of success and gained valuable experience.
I am vastly experienced in all forms of echocardiography (transthoracic, transoesophageal and dobutamine stress echocardiography) and have been performing these investigative procedures for the last 17 years.I get great pleasure in doing these and have been rewarded with numerous remarkable diagnoses.
Cardiac catheterisation & cardiac biopsy
I have been performing coronary angiography since 1996 and have a very large experience of it. I also have particular expertise in right and left heart catheterisation and cardiac biopsies which tie in very well with my heart failure interest. A large proportion of my heart failure patients need one or more of these investigations which I personally perform for them. In particular, patients with heart failure and preserved ejection fraction (HFPEF) are increasing needing haemodynamic measurements via cardiac catheterisation to establish a diagnosis and I perform the investigation for them. Cardiac biopsy is a very specialised procedure that is done only when indicated and I have performed it whenever required.
I would like to make a difference to the lives of people through my academic work. I hope to work tirelessly aiming to improve the understanding of heart diseases that are poorly understood and find new treatments for new medical challenges. Please watch the video (embedded on your left) about a completed trial that I conducted which was funded by the National Institute of Health Research, UK. I am in the process of designing more trials with this technology which, I am very hopeful, will help many in the future, to improve exercise tolerance and leg muscle strength. I have also attached a paper I have recently written on my thoughts about the story of heart failure and how the various types link with each other, for you to read if you are interested. Although I am a strong and passionate clinician I see research reaching out to solve problems in the clinical arena and to me academics is merely the last frontier of clinical work. I have a number of research interests (heart failure, cardiorenal disease, cardiac and elderly rehabilitation) which I am keen to see through to the end.
Photography & poetry
While I can't claim to be an expert in either of these, they are my interests outside of medicine and cardiology. All the images on this site apart from the first two are photographs taken by me. You might have also spotted a few lines of my poetry scattered across the pages. I hope you like them.
I believe deeply in simply caring for patients by being supportive, understanding, encouraging and professional. I have the greatest regard for protecting dignity and independence and for measures that maintain quality of life. I am a great believer in protecting the doctor-patient relationship. I would like to think of myself as someone that can provide a healing touch even in the most difficult of circumstances.